Opjordsmoen Stein, Retterstøl Nils
Division of Psychiatry, Ullevaal University Hospital, Oslo, Norway. s.e.o.ilner@ medisin.uio.no
Psychopathology. 2007;40(5):278-81. doi: 10.1159/000104743. Epub 2007 Jun 28.
Delusions are categorized as present or not in classificatory systems, but can fluctuate in intensity over time. They are sometimes difficult to describe, and might be better conceptualized as continuous on a number of dimensions. The predictive value of dimensional ratings of delusions was studied.
Out of 180 first-episode psychotic patients who had been personally followed up after 30 years, a subsample of 41 was randomly drawn, 21 of the 180, 10 of those with GAS scores of 70 or more, and 10 of those with GAS scores of 30 or less at follow-up. They represented three different groups - a good outcome (n = 17), an intermediate outcome (n = 12), and a poor outcome (n = 12) group. Based on case histories at first presentation, scores on the Dimensions of Delusional Experience Scale were recorded.
Poor compared to good outcome patients had delusions at index admission characterized by more conviction, extension, disorganization, bizarreness and pressure. Intermediate outcome patients had scores in between, but closer to the poor outcome group.
Dimensional rating scales for assessing delusions might have predictive power, and consequently they should be used in future research, and if replicated these findings might have clinical implications.
在分类系统中，妄想被归类为存在或不存在，但随着时间推移其强度可能会波动。它们有时难以描述，或许在多个维度上更好地被概念化为连续的。研究了妄想维度评分的预测价值。
在180例30年后接受个人随访的首发精神病患者中，随机抽取41例作为子样本，其中180例中的21例，随访时总体评定量表（GAS）得分70分及以上的10例，以及随访时GAS得分30分及以下的10例。他们代表三个不同的组——良好结局组（n = 17）、中等结局组（n = 12）和不良结局组（n = 12）。根据首次就诊时的病历记录，记录妄想体验量表维度的得分。
与良好结局患者相比，不良结局患者在首次入院时的妄想具有更强的坚信度、更广泛的内容、更紊乱、更怪异和更强烈的压力感。中等结局患者的得分介于两者之间，但更接近不良结局组。
评估妄想的维度评定量表可能具有预测能力，因此应在未来研究中使用，如果这些发现得到重复，可能具有临床意义。
